A Comparative Study of Residual Volume in Donors for Living Donor Liver Transplantation

Abstract

Abstract Introduction Living donor liver transplantation (LDLT) was introduced in 1989 to overcome the severe shortage of size-matched DD organs for pediatric recipients. Given the increasing shortage of DD grafts for adults in North America and Europe, living donation (LD) was now being explored as a potential solution to the shortage of DD organs for adults also. Aim This study aims at the exploration of this last point. Whether or not minimizing the residual volume in donors after LDLT affects donors’ morbidity. Concentration will be on postoperative donors’ bilirubin level, liver transaminases pattern and complications according to Clavien’s scale. Patients and Methods It is a Comparative Retrospective Observational Cohort study included 44 liver donors operated upon in Ain Shams Specialized Hospital Liver Transplantation Unit and in Egypt Air Liver Transplantation Unit from January 2014 to April 2017. Results There was no significant difference between two groups regards age, gender, fibrosis, steatosis, operation center, postoperative bilirubin (After how many days it returned to normal, maximum and mean postoperative bilirubin), postoperative complications (didn’t pass grade 2 in group A and grade 3 in group B), liver enzymes (postoperative AST and ALT) and Hospital stay, There were no difference between the two groups in the follow up except for elevation of liver enzymes that didn’t return to normal for more than 15 days in donor 9 and elevation of bilirubin in donors 3, 4 and 10 in group (A) and in donors 13, 24, 25, 26, 32, 33 and 43 in group (B). Conclusion It is concluded that donors with low RVs “not less than 33%” could be chosen and operated upon with no significant complications postoperatively that could affect donors’ safety, We suggest that regular follow up of donors is recommended for 5 years. Also more research regarding RV, donors’ safety, selection and complications is recommended as Egypt is the first country in liver disease worldwide.